Number of passengers who have reported being ill during the voyage out of total number of passengers onboard: 204 of 2,613 (7.81%)

Number of crew who have reported being ill during the voyage out of total number of crew onboard: 16 of 1,255 (1.27%)

Predominant symptoms: vomiting, diarrhea

Causative agent: Norovirus

Actions: In response to the outbreak, Cunard Line and the crew aboard the ship are taking the following actions:

Staff served buffet with attention to disinfection of seating and tables,

Extra medical staff and a public health officer sent to the ship,

Contract cleaners employed to clean and disinfect the New York Terminal, targeting hand-contact areas in zones which could be touched by disembarking and embarking passengers,

Increased cleaning and disinfection procedures according to their outbreak prevention and response plan,

Making announcements to notify onboard passengers and crew of the outbreak, encourage case reporting, and encourage hand hygiene,

Collecting stool specimens from ill passengers and crew with plans to send them to the CDC lab for analysis,

Making twice daily reports of gastrointestinal illness cases to the VSP,

Is consulting with CDC on plans for their comprehensive sanitation procedures in Brooklyn, NY on January 3, 2013, including:

Early notification of the outbreak to embarking guests and those continuing on the next cruise to Southampton,

Delayed embarkation of new passengers to allow additional time in port for extensive public and accommodation area touch point cleaning and disinfection,

Staged disembarkation for active cases to limit the opportunity of illness transmission to well guests, and planning for sanitation of terminal and transport infection control procedures.

Two CDC Vessel Sanitation Program environmental health officer and an epidemiologist will board the ship on arrival in Brooklyn on January 3, 2013 to conduct an environmental health assessment and evaluate the outbreak and response activities.